Applying the FIFA 11+ program pre and post-training

Soccer is the most popular sport worldwide, and the most-played outdoor team sport in Australia. Unfortunately, soccer injuries are common, costly, and often devastating for the player. Until recently, the most effective injury prevention program available was the Fédération Internationale de Football Association (FIFA) 11+ exercise program delivered before training sessions.

Comprised of 15 very specific exercises, the FIFA 11+ includes: a running and active stretching element; a core and leg strengthening element; and a high-speed planting and cutting element. On average across all the randomised trials that have investigated the FIFA 11+, teams that undertake the FIFA 11+ before training sessions reduce their risk of injury by 35% (Injury RIsk Ratio 0.65, confidence interval 0.54 to 0.80).

The current study has identified a way to make the FIFA 11+ much more effective. A large trial was conducted with 344 players (21 teams). Teams were randomised to use the FIFA 11+ before training sessions (ie, the traditional approach) or both before and after training sessions (ie, the experimental approach). The theory is that training in a fatigued state (post-training) might help players learn to control their movements while in this fatigued state, thereby providing a mechanism for reducing injury.

The trial results certainly supported the authors' hypothesis. During one season, there were 82 injuries among the 136 players using the traditional approach, whereas there were only 26 injuries among the 144 players who used the FIFA 11+ both before and after their training sessions. That's a reduction in the risk of injury of 72% (Injury Risk Ratio 0.28, confidence interval 0.18 to 0.44). Another way to report that result is that for every 5 players who add the FIFA 11+ after training (compared to only using it before training), one injury will be prevented.

Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!

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